甘油三酯/高密度脂蛋白胆固醇比值与社区糖尿病高危人群自然转归的相关性研究

目的探讨甘油三脂(triglyceride, TG)/高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)比值与社区糖尿病高危人群自然转归为糖尿病的相关性。方法采用《中国2型糖尿病防治指南(2017年版)》中对成年人中糖尿病高危人群的筛查标准,纳入自2012年至2017年间共5年中,来自石河子地区的13个社区中的共261例糖尿病高危患者,纳入人群均曾在我院就诊且连续随访满3年,其中有64例三年内转归为糖尿病,有197例三年后未转归为糖尿病。运用倾向性评分(Propensity score matching,PSM),以年龄、性别、BMI为协变量构建logistic回归模型,对两组患者采用1∶1最邻近匹配法,得到组间协变量均衡的样本,共有64对患者匹配成功,匹配后的样本按照随访期间有无新发糖尿病分为转归组(64例)和未转归组(64例)。首先对两组患者首次就诊时收集的临床信息及生化指标进行单因素分析,然后以年龄、性别、BMI、腰臀比、吸烟史、饮酒史、收缩压、舒张压、合并高血压、合并冠心病、合并脑血管病、糖尿病家族史、空腹血糖(fasti...

Correlation between TG/HDL-C ratio and the natural outcome of high-risk population in community diabetes

Objective To investigate the correlation between TG/HDL-C ratio and the natural outcomes of diabetes in high-risk community groups. Methods The screening standard for high-risk adults with diabetes in the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 Version) was adopted. A total of 261 high-risk patients from 13 communities in Shihezi region were included in the study from 2012 to 2017. All the enrolled patients had been treated in our hospital and followed up for three consecutive years. Among them, 64 cases got diabetes within three years, and 197 cases did not. The PSM was used to construct a logistic regression model with age, gender and BMI as covariables. The 1:1 nearest neighbor matching method was adopted to obtain the samples with covariate equilibrium between the groups. A total of 64 pairs of patients were successfully matched. According to whether new diabetes occurred during the follow-up period, the matched samples were divided into the outcome group (64 cases) and the non-outcome group (64 cases). Firstly, the clinical information and biochemical indexes of the two groups were analyzed by single factor analysis, and then factors including age, gender, BMI, waist-to-hip ratio, smoking history, drinking history, systolic blood pressure, diastolic blood pressure, combined hypertension, combined coronary heart disease, combined cerebrovascular disease, family history of diabetes, fasting plasma glucose (FPG), 2 hours postprandial blood glucose (2hPG), TG, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), HDL-C, TG/HDL -C were used as the independent variable. Multivariate logistic regression analysis was used to determine whether it was converted to diabetes during the 3-year follow up. Results Univariate analysis showed that TG/HDL-C ratio, 2hPG, TG, TC, LDL-C and coronary heart disease ratio were all higher in the treatment group than those in the control group, and HDL-C was lower in the treatment group than that in the control group, with statistically significant differences (P<0.05). Multivariate regression analysis showed that coronary heart disease (OR=15.483, 95%CI: 1.395~171.870, P=0.026), 2hPG (OR=1.912, 95%CI: 1.334~2.740, P<0.001), TG/HDL-C (OR=15.235, 95%CI: 4.405~52.684, P<0.001), TC (OR=1.882, 95%CI: 1.100~3.221, P=0.021) were independent risk factors for diabetes. Conclusion TG/HDL-C ratio is an independent risk factor for the outcome of high-risk groups with diabetes, and may be a predictor of the outcome of high-risk groups with diabetes.